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Sapmaz Ucan C, Dumani A, Unal I, Yilmaz S, Yoldas O. Effect of QMix as final irrigation protocol on periapical healing after single-visit root canal treatment: A randomised controlled clinical trial. AUST ENDOD J 2023; 49 Suppl 1:113-121. [PMID: 36254883 DOI: 10.1111/aej.12701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 09/01/2022] [Accepted: 10/03/2022] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate radiographic periapical repair after endodontic treatment using QMix or NaOCl irrigation in single-rooted teeth with apical periodontitis. In this randomised clinical trial, 60 patients were selected and randomised into two groups (n = 30). After instrumentation of root canals, QMix or NaOCl was used as a final irrigation and the canals obturated with gutta-percha and AH Plus sealer. All the participants were recalled after 12 months and 15 patients were lost to the study so 45 patients were evaluated radiographically according to periapical index (PAI) scores. A significant decrease was seen in PAI scores after 1 year in all patients (p < 0.001). In the QMix and NaOCl group, absence or reduction of radiolucency was observed in 23 of 25 teeth (92%) and 20 of 20 teeth (100%), respectively. There was no significant difference between two groups according to the decrease in PAI score (p = 0.508). Root canal treatments with or without QMix irrigation contributed equally to periapical healing.
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Affiliation(s)
- Cemre Sapmaz Ucan
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Aysin Dumani
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Ilker Unal
- Department of Biostatistics, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Sehnaz Yilmaz
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Oguz Yoldas
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
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Silva AM, Alencar CDM, Jassé FFDA, Pedrinha VF, Zaniboni JF, Dantas AAR, de Campos EA, Kuga MC. Effect of post-space irrigation with acid solutions on bond strength and dentin penetrability using a self-adhesive cementation system. J Clin Exp Dent 2021; 13:e564-e571. [PMID: 34188762 PMCID: PMC8223157 DOI: 10.4317/jced.58029] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/20/2021] [Indexed: 12/03/2022] Open
Abstract
Background The aim of this study was to evaluate the effects of surface treatments with 1% peracetic acid (PA), solution containing 17% EDTA (SmearClear, Kerr Endodontics), solution containing a combination of 17% EDTA with 2% chlorhexidine (QMix, Dentsply Sirona) on the post-space root dentin compared to 2.5% sodium hypochlorite (NaOCl) on bond strength and resin tags length in dentin.
Material and Methods Forty human-canine roots were endodontically treated and the post space was prepared. The specimens were randomised into four groups (n = 10): control – irrigation with 2.5% NaOCl solution, PA – irrigation with 1% PA, SmearClear – irrigation with SmearClear solution, and QMix – irrigation with QMix solution. The fibre posts were cemented using a self-adhesive resin system (Relyx U200, 3M ESPE). After six months, the specimens were cross-sectioned and subjected to push-out and confocal laser microscopy tests. One-way ANOVA and Tukey’s tests were used to analyse the data (α= 0.05).
Results PA and QMix presented the highest bond strength values compared to the other groups (p< 0.05). There was no significant difference between the resin tags length in dentin by the groups (p = 0.75).
Conclusions Irrigation of the post space with 1% PA and QMix showed a positive clinical impact on the adhesion between the fiber post and root dentin. However, these materials had no influence on resin tags length in dentin by self-adhesive resin cement. Key words:Fiber post, adhesive cementation, self-adhesive resin cement, root dentin, irrigating solutions.
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Affiliation(s)
- Aryvelto-Miranda Silva
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Cristiane-de Melo Alencar
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | | | - Victor-Feliz Pedrinha
- Department of Restorative Dentistry, Bauru School of Dentistry, University of Sao Paulo (USP), Bauru, SP, Brazil
| | - Joissi-Ferrari Zaniboni
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Andréa-Abi-Rached Dantas
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Edson-Alves de Campos
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Milton-Carlos Kuga
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
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Saricam E, Küçük M, Akyol M. Evaluation of EDTA, QMix, and Irritrol solutions activated with Er,Cr:YSGG and diode lasers on the push-out bond strength of filling material. Microsc Res Tech 2021; 84:584-591. [PMID: 33044039 DOI: 10.1002/jemt.23616] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 09/16/2020] [Accepted: 09/26/2020] [Indexed: 11/06/2022]
Abstract
This study was conducted to evaluate the effects of ethylenediaminetetraacetic acid (EDTA), Irritrol, and QMix solutions used with manual irrigation and diode and erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser activation on the bonding ability of sealer to the intraradicular dentin. The root canals of 90 mandibular incisors were instrumented, and the teeth were allocated randomly to nine groups (n = 10/group) receiving final irrigation with different irrigation solutions (EDTA, Irritrol, and QMix) and irrigant activation techniques (manual, diode laser, and Er,Cr:YSGG laser). Following endodontic filling, three sections of 1-mm thickness were obtained from the middle third of each root. The root filling was subjected to a push-out test to examine the bond strength of the sealer to dentin. The test data were examined using analysis of variance with a significance level of ɑ < .05. Failure modes were determined by stereomicroscopy, and the surface characteristics of dentin were observed by scanning electron microscopy. Irritrol showed less push-out bond strength than did the other solutions in the Er,Cr:YSGG laser groups (p < .05). In the diode laser groups, QMix provided greater adhesion than did Irritrol (p < .05). The activation of QMix with the Er,Cr:YSGG laser increased the bond strength more than did manual irrigation (p < .05). No other significant difference was observed between other comparison pairs (p > .05). QMix provided adhesion superior to that of Irritrol when activated with diode and Er,Cr:YSGG lasers. Er,Cr:YSGG laser activation increased the adhesion of filling material with QMix irrigation.
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Affiliation(s)
- Esma Saricam
- Department of Endodontics, Faculty of Dentistry, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Meltem Küçük
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin, Turkey
| | - Meltem Akyol
- Tepebasi Oral and Dental Health Education Hospital, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
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Ulusoy Öİ, Mantı AŞ, Çelik B. Nanohardness reduction and root dentine erosion after final irrigation with ethylenediaminetetraacetic, etidronic and peracetic acids. Int Endod J 2020; 53:1549-1558. [PMID: 33448412 DOI: 10.1111/iej.13372] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/22/2020] [Accepted: 07/24/2020] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the nanohardness reduction and erosion in root canal dentine after application of 17% ethylenediaminetetraacetic acid (EDTA), 9% etidronic acid (HEBP) and 2% peracetic acid (PAA) either alone or combined with sodium hypochlorite (NaOCl). METHODOLOGY One hundred and sixty single-rooted teeth were decoronated and their root canals were chemomechanically prepared. For the nanohardness evaluation, 80 roots with instrumented canals were split longitudinally into two halves. Dentine blocks with a length of 7 mm were obtained from the middle third of one half of each tooth and were embedded in epoxy resin blocks exposing the root canal walls. Initial nanohardness values of root canal dentine were measured for each specimen using a nanoindenter with a Berkovich tip. The specimens were divided into seven experimental (n = 10) and one control (n = 10) group according to the final irrigation regimens: Group 1: 2.5% NaOCl, Group 2: 17% EDTA, Group 3: 2.5% NaOCl-17% EDTA, Group 4: 2% PAA, Group 5: 2.5% NaOCl-2% PAA, Group 6: 9% HEBP, Group 7: 2.5% NaOCl + 9% HEBP and Group 8: Distilled water (control). The measurement of the nanohardness values was repeated for each specimen after being exposed to the irrigants. The nanaohardness reduction of each sample was calculated and recorded. The other 80 instrumented root canals were used for scanning electron microscope (SEM) evaluation. First, they were irrigated with the same protocols stated above and longitudinally split into two halves. One half of each root canal was viewed using SEM for the amount of erosion. The erosion scores were recorded. Data were analysed statistically using Kruskal-Wallis and Bonferroni-adjusted Mann-Whitney U-tests with a significance level of 0.05. RESULTS Use of etidronic acid and NaOCl + HEBP reduced the nanohardness values significantly more than the other experimental solutions (P < 0.05). There was no significant difference between the values for the nanohardness reduction in the samples irrigated with a single chelator and chelator combined with NaOCl (P > 0.05). Peritubular and intertubular erosion were observed in the samples irrigated with HEBP and NaOCl + HEBP. CONCLUSION Final irrigation of root canals using etidronic acid alone or combined with NaOCl was associated with structural alterations in root canal dentine of extracted teeth.
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Affiliation(s)
- Ö İ Ulusoy
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - A Ş Mantı
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - B Çelik
- Department of Statistics, Faculty of Science, Gazi University, Ankara, Turkey
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Emre Erik C, Onur Orhan E, Maden M. Qualitative analysis of smear layer treated with different etidronate concentrations: A scanning electron microscopy study. Microsc Res Tech 2019; 82:1535-1541. [PMID: 31187914 DOI: 10.1002/jemt.23318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 04/02/2019] [Accepted: 05/29/2019] [Indexed: 11/10/2022]
Abstract
The aim of this study was to examine the smear layer removal capacity of various etidronate treatments. Seventy-eight roots were instrumented up to apical size X4 and randomly divided into five treatment groups and a positive control group (n = 13). Groups were as follows: irrigation with 5 ml of sterile saline (control) for 3 min, 5 ml of 17% ethylenediaminetetraacetic acid (EDTA) for 3 min, 5 ml of 9% A1-hydroxyethylidene-1,1-bisphosphonate (HEBP) for 3 min, 5 ml of 18% HEBP for 3 min, irrigation with 5 ml of 1% sodium hypochlorite (NaOCl) + 9% HEBP for 3 min, and 5 ml of 2% NaOCl + 18% HEBP for 3 min. The roots were examined using a scanning electron microscope. The smear layer scores in the 2% NaOCl + 18% HEBP group were lower than those in the other treatment groups and the control group (p < .05). There were no significant differences among the treatment groups in the smear layer scores of the coronal and middle thirds. However, the smear layer scores in the 2% NaOCl + 18% HEBP treatment group were lower those in the 9% HEBP and 18% HEBP treatment groups in the apical third (p < .05). In the clinical setting, the recommended concentration of HEBP is 18%, and it should be used with an oxidizing agent to ensure optimum smear layer removal.
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Affiliation(s)
- C Emre Erik
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | - E Onur Orhan
- Department of Endodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Murat Maden
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
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Souza MA, Bonacina LV, Ricci R, Padilha Rauber MG, Zuchi N, Hoffmann IP, Bischoff KF, Engelmann JL, Palhano HS, Cecchin D. Influence of final irrigation protocols and type of resin cement on bond strength of glass fiber posts in root dentin previously treated with photodynamic therapy. Photodiagnosis Photodyn Ther 2019; 26:224-228. [DOI: 10.1016/j.pdpdt.2019.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/26/2019] [Accepted: 04/05/2019] [Indexed: 11/28/2022]
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Influence of final irrigation protocols and endodontic sealer on bond strength of root filling material with root dentin previously treated with photodynamic therapy. Photodiagnosis Photodyn Ther 2019; 26:137-141. [DOI: 10.1016/j.pdpdt.2019.03.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/18/2019] [Accepted: 03/18/2019] [Indexed: 11/21/2022]
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Nogo‐Živanović D, Kanjevac T, Bjelović L, Ristić V, Tanasković I. The effect of final irrigation with MTAD, QMix, and EDTA on smear layer removal and mineral content of root canal dentin. Microsc Res Tech 2019; 82:923-930. [DOI: 10.1002/jemt.23239] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/14/2019] [Accepted: 01/31/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Dajana Nogo‐Živanović
- Department for Restorative Dentistry and Endodontics, Faculty of MedicineUniversity of East Sarajevo Foca Bosnia and Herzegovina
| | - Tatjana Kanjevac
- Department of Dentistry, Faculty of Medical SciencesUniversity of Kragujevac Kragujevac Serbia
| | - Ljiljana Bjelović
- Department for Restorative Dentistry and Endodontics, Faculty of MedicineUniversity of East Sarajevo Foca Bosnia and Herzegovina
| | - Vladimir Ristić
- Department of Dentistry, Faculty of Medical SciencesUniversity of Kragujevac Kragujevac Serbia
| | - Irena Tanasković
- Department of Histology and Embryology, Faculty of Medical SciencesUniversity of Kragujevac Kragujevac Serbia
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Jiayi W, Ruijie H. [Research progress on QMix properties in root canal irrigation]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2017; 35:543-548. [PMID: 29188654 DOI: 10.7518/hxkq.2017.05.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Mechanical instrumentation preparation alone is insufficient to completely remove root canal infection, and chemical irrigation is essential to eliminate infected remnants. An ideal root canal irrigant should completely remove the smear layer, lubricate the root canal, efficiently kill bacteria, induce mild or no inflammatory response in the tissues, and avoid damaging the dentin structure. However, a commercial irrigant that meets all these requirements is currently lacking. QMix is a root canal irrigation mixture of ethylenediamine tetraacetic acid (EDTA), chlorhexidine (CHX) and surfactant. This mixture can remove the smear layer efficiently, and it possesses strong antibacterial effect and good biocompatibility with minimal cytotoxicity. Furthermore, the influence of QMix on the color and micro-hardness of dentin is low, and it can improve the wettability of root canal sealant without affecting its adhesive properties. This review compares the efficiencies of QMix with other irrigants (sodium hypochlorite, CHX, EDTA, SmearClear, and MTAD) in term of smear layer removal, dentine and root canal sealing, cell cytotoxicity, and bacterial growth inhibition.
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Affiliation(s)
- Wu Jiayi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Huang Ruijie
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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